Transcript Dr. Nadav Pam - Israeli Dermatology Assosiation - 35th annual

Medical evidences of the
therapeutic effect of edible gelatin
on telogen effluvium and androgenetic alopecia
in both men and women
By Nadav Pam M.D.
Research and Development
Aripam Medical Center, Ashdod, Israel.
Email: [email protected]
• Family: Married to Sara and father to Ori and Nadav.
• 1978: Graduated from the School of Medicine at the
Technion, Haifa, Israel.
• 1979 – 1985: Medical doctor at I.D.F
• 1985 – 1990: Resident in the department of
dermatology in Rambam hospital, Haifa.
• 1997: A member of the American Academy of
Dermatology (AAD).
• 1991- 2013: Chief executive officer of Aripam Medical
Center, one of the largest dermatological clinics in
southern Israel. Aripam Clinic is the leading clinic in
Israel in Acne phototherapy & esthetic treatment.
• 2001: He was the a co-author with Dr. Samuel Yorav
of the book , titled: “Acne the real story” .
Gelatin and safety
• In 1993 the FDA reiterated the “GRAS” (Generally Reconsidered
As Safe) status of gelatin and stated that there was no
objection to the use of gelatin from any source and any
country provided that the hide from animals showing signs of
neurological disease were excluded and also specified raw
materials were excluded from the manufacturing process
• In the year 2000 the European Union approved the use of
gelatin
• In the lecture of Infusion and transfusion therapy by Dr.
Madách Krisztina, gelatin is used as an artificial colloid and is
used as an I.V. plasma expander with estimated time of 90-120
min and it has the smallest influence on homeostasis among
the artificial colloids such as: HES (hydroxyethyl starches) and
Dextran (40 Rheomacrodex, 70 Macrodex)*
*Dr. Madách Krisztina, Semmelweis University Department of Anesthesiology and Intensive Therapy, titled:
"Volume resuscitations, pros and cons of crystalloids and colloids, indications and pitfalls of transfusion
therapy", 2008 , slide 29/33.
The hypothesis of therapeutic effect of oral gelatin on
hair loss in both men and women
1. Gelatin exhibited one of the highest specific dynamic effects of any food which is
caused by increase peripheral blood flow. Increased blood flow had been shown
to increase the growth rate of some tissues in both animals and men.
2. Gelatin causes vasodilation of peripheral blood vessels therefore improving the
hair follicle blood circulation.
3. Gelatin is composed of 18 amino acids which are delivered via the blood stream
to the hair follicle which are the building blocks for hair follicle growth.
4. The hair follicle stays longer time in the anagen stages due to increase availability
of the amino acids provided by gelatin consumption.
5. Delaying the progression of the miniaturization of the hair follicle in androgenic
alopecia by mechanisms mentions above (1, 2, 3, 4).
6. It is possible that there are changes of signals with the milieu of amino
acids in gelatin, through change of proteins produced and released
within the hair follicle that promotes and stimulates hair growth in the
anagen stage.
The specific dynamic action of gelatin*
• As early as 1926, Rapport et al., discovered that gelatin
exhibited one of the highest specific dynamic effects of any food
• The increase in body temperature due to specific dynamic effect
was thought to be cause by an increase in peripheral blood flow
• This hypothesis is supported by an article in which finger blood
volume was found to increase following gelatin ingestion
• Moreover, increased blood flow had been shown to increase the
growth rate of some tissues in both animals and men
* THE SPECIFIC DYNAMIC ACTION OF GELATIN HYDROLYSATES by DAVID RAPPORT, From the Department of Physiology, Western
Reserve University Medical School, Cleveland. Received for publication, October 8, 1926. Published the American Society of Biological
Chemists, Inc., Vol 71. p. 75-86 in English.
Food Derived Collagen Peptides in Human
Blood after Ingestion of Gelatin*
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Identification of several food
derived collagen peptides in
human blood after oral ingestion
of gelatin.
Healthy
human
volunteers
ingested gelatin hydrolysates 9.4g
- 23g from porcine skin, chicken
feet and cartilage and after 12h of
fasting.
After oral ingestion the peptide
form of hydroxyproline (Hyp)
significantly
increased
and
reached a maximum level of 2060 nmol/ml after 30-60 min and
then decreased to half of the
maximum level at 5h after
ingestion.
The ratio of the peptide form of
Hyp to the free one was
approximately 1:3.
Major constituents of food
derived collaged peptides in
human serum and plasma were
identified as Pro-Hyp.
In addition, small but significant
amount of Ala-Hyp, Ala-Hyp-Glu,
Pro-Hyp-Gly, Leu-Hyp, IIe-Hyp and
Phe-Hyp were contained.
*Koji Iwai, et al. article titled: “identification of food derived collagen peptides in human blood after oral ingestion of gelatin Hydrolysates.
Department of Food Sciences and Nutritional Health, Kyoto Prefectural University, Japan. Published at the journal of agricultural and food
chemistry. 2—5. 53, 6531-6536. DOI 10.1021/jf050206p. Published on American Chemical Society 2005.
Gelatin and hair
growth study
groups:
Morganti P., Randazzo
S.D., Bruno C.,
M.P DE Padova., A.
Tosti
Bruno Silvestrini
Hertel H, Gollnick H,
Matthies C, Baumann
I, Orfanos CE.
Morganti P., Fabrizl
G., James B., Bruno c.,
Year of
publication:
1982
1985
1985
1989
1998
Double blind
Subjects were controlled
clinically every 2 weeks
Double blind
Pilot study fallowed by a
double blind study
Randomized double blind
for both diet and solution
in combination and as
stand alone
Description of
volunteers
Total of 40 Italian volunteers from
both sexes with confirmed telogen
effluvium
Total of 60 patients (40 females,
20 males) effected by confirmed
seborrheic alopecia.
40 health volunteers (20 males
and 20 females). Division 2
homogenous groups according to
age and body weight
Pilot study total of 36 patients.
Double blind study with total of
47 patients. In both studies the
patient had alopecia of the diffuse
type.
Total of 48 volunteers (24
women and 24 men) affected
by androgenetic alopecia type
3 and 4 according to
Hamilton.
What was
examined:
Hair samples of 1cm x 1cm
between the rear vertex (VP) and
the frontal vertex (VA) according
to Moretti subdivision
Sebum level was determined by
using the Sebumeter SM 410.
Measurements at : 0,30,60,90
days.
Shaving of the median occipital
region . Same region was shaved
every month. Collection of 10
hairs from each volunteer and
measuring them at 30, 60, 90
days. Measurement by millimeter.
The clinical efficacy was evaluated
by standard methods, such as the
preparation of trichograms and
measurement of the hair density
before and after treatment
Hair mass and the mean hair
number were controlled according
to price et al exclusion. Pre
selected frontal/parietal scalp
area 1 cm2 was hand clipped on
day 0. and at week 10 and at
week 50. Measurement according
to Pirce and Menefee
methodology.
20-40
Not mentioned
18-28
Not mentioned
21-38
Length of diet:
3 months (12 weeks)
3 months (12 weeks)
3 months (12 weeks)
Long term
50 weeks
Type of diet:
4 oral pills in total of 2 g gelatin +
0.8g cysteine per os/day
4 spherules of total of 2 g gelatin +
0.8g cysteine per os/day
First group: 8 grams of oral gelatin
daily mixed in commercial yogurt.
Daily oral combination therapy of
7000 mg gelatin, 70 mg cystine
and 18,000 IE retinol (Vitamin A).
Active diet (12 subjects): gelatin,
soy oil, L-cystine, l-methionine,
Cu, Zn.,
Active lotion: Serenoa Repens,
Azeliac acid, ginkgo bilboa
Starch
N/A
Second group: 8 grams of starch
mixed in commercial yogurt.
Placebo (starch?)
Diet (placebo): Starch and soy oil
Lotion (placebo): water, ginkgo
bilboa, and Azeliac acid.
50% Intense hair growth and
leads to substantial increase
in the diameter of fibers
compared to placebo P<0.05.
A significant reduction of
seborrhea was observed in
30% of the subjects, P<0.05.
Daily ingestion of 100mg/kg
(body weight) of gelatin is a
simple and effective method
for the administration of
those amino acids which are
necessary for enhanced
growth hair in man
Pilot study: reduction of
telogen rate by 8.3, increase
of anagen rate by 11% and
increase in hair density by
6.9%.
Double blind study: decrease
of telogen rate by 13.5% and
increase of anagen rate by
8%.
An increase of hair mass from
20 to 30@ (P<0.005) together
with increase of hair number
from 17 to 27% (p<0.005)
compared to placebo. With
the diet supplement a further
increase of 50% (P<0.05) in
hair growth.
Type of study
Age groups:
Placebo:
Results:
Effect of gelatin-cysteine diet on growth of human hair*
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A favorable effect on the growth of hair has been reported in 1982, by Morganti et al. effect of
gelatin-cysteine diet supplement on growth of human hair. The study was double blind, lasted 3
month, and involved 40 volunteers aged between 20-40 years.
The diet of the volunteers was 2 gram gelatin and 0.8 gram cysteine every day or placebo
(starch tablets).
The results of this study suggested that the dietary supplementation of gelatin and cysteine
combination promoted more intense hair growth and leads to substantial increase in the
diameter of the fibers 1-3.
1. Morganti P., Randazzo S.D., Bruno C, (1982) "effect of gelatin cysteine on hair after a three months treatment“,
J. Soc. Cosmet. Chemists 33, 95.
2. Randazzo S.D., Morganti P., (1982) titled: "The influence of gelatin cysteine supplementation on the amino acids composition of human hair", accepted for presentation on XVI intern. Congress of
Dermatology May 23-28 Tokyo.
3. Morganti P., Bruno C. Colelli G (1983) Geltina - cistina. Cheratogenesi e struttura pilifcra Boil, Soc, It. Biol Sper 59:20.
Gelatin - cystine therapy in seborrheic alopecia*
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In 1986, Padova et al.
published an article on gelatincysteine in seborrheic alopecia
in which, 60 Subjects (40
females, and 20 males) affected
by Seborrhea alopecia took
part.
Each volunteer took four
capsules a day for 3 month.
Every capsule contained 500
mg gelatin and 200 mg lcysteine (In total 2-gram
gelatin and 800 mg cysteine
daily).
The results were significant
reduction in seborrhea in 30%
of the subjects and significant
reduction in sebum level.
*M.P. DE Padova, A. TOSTI, titled: “Gelatin - Cyctine in Seborrheic Alopecia”, department of dermatology university of
Bologna – Italy, February 15, 1985. J Appl. Cosmetol 1968;4;55-60 (April/June 1986).
Gelatin effect in androgenetic alopecia:*
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In yet another article by Morganti et al. he
reexamined the influence of gelatin with the
addition of cysteine and serenoa repens on hair
growth (serenoa repens is commonly known as
saw palmetto and sabal serrulatum, it is a small
palm tree, normally reaching a height of around
2–4 m).
The study was conducted for a long period
application of 50 weeks of a new cosmetic lotion,
on 48 volunteers (24 women and 24 men) aged
between 21 and 38 years, affected by
androgenetic alopecia (type 3 and 4 according to
Hamilton).
12 subjects also took a dietary supplement (4
pills per day) based on gelatin and cysteine. The
solution and the dietary supplement (placebo
and active) were assigned in a randomized
double blind manner.
Hair mass and the mean hair number were
controlled according to Price et al. exclusion
criteria included use of topical or oral drug or
diet supplement within the previous 6 months.
The obtained results showed an increase of hair
mass from 20 to 30% (p<0.005) together with a
contemporary increase of hair number (from 17
to 27%) (p<0.005) compared to the placebo for
subject using the lotion only.
With the diet supplement a further increase of
50% (p<0.005) in hair growth and significant
decrease of blood ROS (Reactive Oxygen Species)
were obtained.
*Morganti P., G. Fabrizl. B james, C. Bruno, titled: “Effect of gelatin-cystine and serenoa repens extract on free radicals level
and hair growth”, Presented at Singapore clinical dermatology 200 – Singapore 18-20 June, 1998
Pam Z., Wikonkal N., Pam N., - 15th Annual Meeting of the European Hair Research Society (EHRS) , Jerusalem, Israel, July 6-9, 2011.
*http://www.ijtrichology.com/article.asp?issn=0974-7753;year=2011;volume=3;issue=3;spage=35;epage=50;aulast=
Supportive clinical data for edible compositions for preventing
hair loss by a pediatric gastroenterologist and nutritionist*
• *Prof. Ram Reifen, M.D., a pediatric gastroenterologist and a
nutritionist IMA Board certified in pediatrics and pediatric
gastroenterology and nutrition;
• Has been treating women post partum, as well as
adolescent girls over 5 years time from 2002-2007.
•
During this time period he treated over ca. 100 Patients with a similar
success rate following accumulation of the above mentioned results by
Dr. Zeev Pam.
**Inventor Zeev Pam -United states patent application publication: Pub. No.: US 2012/0142598-A1Jun.7.2012. http://www.freepatentsonline.com/20120142598.pdf
Results of gelatin in female pattern hair loss
• The clinical results in TE are faster than in AGA.
• In TE the recommended duration of the treatment is 3–6 months while in
AGA the clinical treatment is at least 12 months.
• In females who have both TE and AGA the treatment time depends on
clinical results.
Results of gelatin in male pattern hair loss
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The recommended duration of the treatment in male pattern hair loss is at least 3-6 months of daily
dosage of 1.5g-3g of gelatin .
According to Dr. Zeev Pam, clinical experience the treatment for male pattern hair loss may even be
longer than 6 month with the dosage of 1.5-3 grams gelatin daily or even higher as a gelatin tablet or as
gelatin powder.
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Dr. Zeev Pam, theorized that gelatin supplementation is beneficial in the early stages
of androgenic alopecia by dilation of the peripheral blood vessels and supplying the
necessary amino acids for the hair follicle and delaying the worsening of the
androgenic alopecia stages.
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Dr. Zeev Pam, suggested that there is a beneficial results from the combination therapy of gelatin with
other methods such as: 1. LLLT 2. vitamins and other food supplements and extracts such as: biotin,
taurine, zinc, green tea, silica, grape seed, saw palmetto. 3. fatty acids 4. drugs for hair loss treatment
such as finasteride , minoxidil and topical revivogen.
Medical indication for the use of
gelatin for hair diseases
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Seborrheic alopecia1
Improve alopecia of the diffuse type2
Androgenetic alopecia3
Telogen effluvium4
Improves linear growth and diameter of hair5
1. M.P DE Padova, A. TOSTI, title: “Gelatin - Cyctine in Seborrheic Alopecia”, department of dermatology university of Bologna – Italy, February 15, 1985.
J Appl. Cosmetol 1968;4;55-60 (April/June 1986).
2. Titled: “Low dosage retinol and L-cystine combination improve alopecia of the diffuse type, following long-term oral administration”. By Hertel H, Gollnick H, Matthies C,
Baumann I, Orfanos CE. Universitäts-Hautklinik und Poliklinik, Freien Universität Berlin. Hautarzt. 1989 Aug;40(8):490-5.
3. Morganti P., G. Fabrizl. B james, C. Bruno, titled: “Effect of gelatin-cystine and serenoa repens extract on free radicals level and hair growth”, Presented at Singapore
clinical dermatology 2000 – Singapore 18-20 June, 1998
4. Zeev Pam, M.D. presented a lecture titled: "Low dosage gelatin based treatments with single dose, daily, for minimum of 3-6 months in female pattern hair loss."
Presented at the first International Annual Convention on the advance in hair research of the Israeli Society of Dermatology and Venereology at the Technion, faculty of
medicine, Israel, in June 2010
5. Randazzo S.D., Morganti P., titled: "The influence of gelatin cysteine supplementation on the amino acids composition of human hair", accepted for presentation on XVI
intern. Congress of Dermatology May 23-28, 1982, Tokyo.
Acknowledgments
On behalf of the Pam Family: Sara, Ori and Nadav
We would like to thank Prof. Dr. Eli
Sprecher and all the members of the
Israeli Dermatology Association for
honoring the memory of our
beloved Zeev Pam 1953-2013.